Individual provider Active NPI

Amanda Eilefson

  • Behavior Analyst
  • Silverdale, WA
National Provider Identifier
1104229491
Registry record updated Oct 1, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
License
CG60497315 Issued in WA
Practice address
3500 NW Bucklin Hill Rd
Silverdale, WA 98383-8503
Phone
(360) 337-2222
NPI assigned
Oct 1, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 1, 2014

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Analyst 103K00000X CG60497315 WA Primary

Addresses

Primary practice location

3500 NW Bucklin Hill Rd
Silverdale, WA 98383-8503

Mailing address

3500 NW Bucklin Hill Rd
Silverdale, WA 98383-8503

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
CG60497315WAMDBehavioral Analyst

Practice roles

OrganizationSpecialtyStatusNew patients
Olympic Penninsula Autism Center Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1412121600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1412121600000",
    "number": "1104229491",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3500 NW BUCKLIN HILL RD",
            "city": "SILVERDALE",
            "state": "WA",
            "postal_code": "983838503"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3500 NW BUCKLIN HILL RD",
            "city": "SILVERDALE",
            "state": "WA",
            "postal_code": "983838503",
            "telephone_number": "360-337-2222"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EILEFSON",
        "first_name": "AMANDA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-10-01",
        "last_updated": "2014-10-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "WA",
            "license": "CG60497315",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Silverdale, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.